Letter to the new (infertile) kid on the block

Dear newbie,

Whether you know me personally or not, I was you. I was at the beginning of this supremely shitty journey once.

A brief aside: I kinda hate the word journey. It’s both overused and trite, particularly in the context of infertility. It implies a destination ahead. And many days, you’ll have one. A baby in your sights. Some days, though, that destination may need to be relief from the physical and emotional pain you’re likely to experience. I’m truly sorry that you’ll feel this hurt.

When I was where you are on this road (that word somehow feels a bit more natural to me), I had few resources to talk me through what was to come. That was lonely, and it sucked. I hope that you’re able to take an exit ramp long before where I am now, but no matter where you depart, know that you’re never alone. Infertility is probably going be the most alienating thing you ever experience. It has been even more so than the chronic depression I’ve struggled with, although I’ve found they go hand in hand for me.

If you’re reading this, then you’ve likely found that within a few Google searches you can find others online like you. I urge you to use the web wisely, though. Seek out forums, communities and blogs that can be a source of strength for you. Just read, or share your own experience. Step away when the web becomes alarmist. Reading others experiences can be helpful, but do your best not to let these stories trigger your own fears. You’ll have created plenty in your own brain. Don’t fuel them. Remember that every woman is different and none of us have all the answers. That thought alone will probably land somewhere between comforting and frightening, and that’s okay.

When you’re ready, share your thoughts and feelings with someone. That person can be your partner, but it doesn’t have to be. Not every partner will be able to relate to the myriad of thoughts and feelings you’re having. That’s okay, too. They may grieve losses and manage anxieties differently than you do. It can make you crazy, but give them space to process infertility in their own way. It’s their struggle, too. Instead, or in addition to, seek out a therapist, a family member, a friend — whom ever you can feel comfortable and safe with. Resolve offers many peer-led support groups across many cities. When you find one, I urge you to give it a try. Talking aloud does help you feel less lonely. The strength of the women I’ve met in my local group can prop up the world. I’m grateful I can share in that.

This road may get scary. I’m sorry for that, too. I hope that those periods of fear are brief for you. If you do feel yourself wearing a little too thin, though, put yourself first. Advocate for yourself with your doctor. Ask the questions. Sometimes a little more information or a less jargony explanation can help ease your fears. Remember that the end goal of a baby isn’t the only thing that matters. You do, too. You’re here now, and this road is hard.

Sometimes you will feel afraid and empty, but you’re not a failure. What your body can or cannot do doesn’t determine your worth. I’ve spent far too many sleepless nights and dazed commutes focusing on how my body has failed me. Those thoughts only multiplied my frustration and left me drained of hope. Never once were they productive. Remember to be kind to yourself.

I don’t yet have a happy ending to my story to share with you. You’ll hear a lot of stories about how your friend’s cousin’s stepsister-in-law got pregnant after she stopped trying and relaxed. Each one will probably make you want to scream and curse. That’s okay. I hate hearing them, too. The majority of people who offer these stories have no idea what you’re navigating right now. They just want to offer their support. If someone who loves you asks if they can do anything for you, tell them what you need. Or at least ask for homemade brownies during your next two week wait. Those never hurt.

You can do this. So can I.

Your fellow infertile sister,

Ashley

pexels-photo-305264

Photo by David Whittaker via Pexels

Advertisements

What if there’s nothing left

2018. Will this be the year that we finally… no, don’t bother finishing that sentence. We all know how it goes, right?

We started with our fertility clinic in January of 2015 after trying for two years. 2018 will be the end of this road, no matter where it leads.

We’re putting together the financials for one more stim cycle, to hopefully begin shortly after the new year. I’ll pump myself full of hormones until my belly feels ready to pop, and then we’ll wait. Hold our collective breath to see if we have any normal embryos.

Last time I stimmed, my doctor retrieved 23 eggs. Those resulted in only six blastocysts. One of which remains frozen and waiting. I remember being excited to hear that we had six. I thought, well I’m certainly not going to have six kids, so we’re fiiiine. Naive. I was tested but still untested.

This time I will be nearly two years older. To my credit (since I take so little of it), my AMH is still good for 36. I have little doubt that stimming this time will be easy. Easy in the sense that my body will respond appropriately. But not easy at all.

Listen, I’m terrified that we won’t get any normal embryos after PGS testing. That’s what I just have to say. The five previously were not good, but we didn’t know that then. 3AB and her Frozen siblings, Anna, Elsa, Olaf and, then, Anakin. None of them found their home.

I liked the whimsy of having named my embryos. It brought me some levity to the science of it all. But I’m not sure I can name them this time. Really, I just want at least one to have the option of naming.

Just give me one and I’ll shut the hell up.

Maybe you’re just too fat to have a baby and other things no one said but I heard in my head

I’ve struggled with my weight for much of my adult life. I was very active in as a kid and through my teen years, and with only a few exceptions of the low-fat lifestyle trends of the 90s, I didn’t think all that much about what I ate. I started pretty steadily putting on weight in college, but for much of my early 20s remained only about a size or two bigger than I was when I graduated. I wouldn’t call myself a yo-yo dieter, but an slowly-moving, unmotivated yo-yo is a fairly apt description of my weight after 26 or 27.

Three years into fertility treatments, the scale isn’t too kind to me. It started to tick up when I started Clomid, then exploded during the transition from IUIs to IVF. Much of this was related to the hormones pumping through my body. It is also more literally tied to eating ice cream to dull the feelings of unsuccessful cycles, miscarriages and feeling like I’m completely broken. I can own that. All total I put on about 35 pounds in these three years and, in October when I met with the doctor offering a second opinion, was the heaviest I’ve ever been.

Over the course of that conversation, the new RE suggested that because of my weight, I was probably producing poor quality eggs, resulting in poor quality embryos, leading to lack of implantation. I wasn’t shocked by this assessment, but I was taken aback. This wasn’t a factor on the table with my Peyton Manning doctor. He never once said to me that I should consider putting the spoon down. I’d certainly read a bit online about BMI affecting egg quality, but if I’d asked and my doctor didn’t think it was the reason for three years of ultimately unsuccessful treatments, then it probably wasn’t… right?

In the moment, I left that RE’s office feeling absolutely deflated (like Tom Brady’s footballs… [I’m just going to keep running with these weird football analogies, so roll with it]). It was a deep cut to hear that my weight could be preventing me from achieving success. He’d told me that to take me on as a new patient, he’d want me to first lose 20 pounds. Twenty pounds caused by Clomid and ice cream and Estrace and pizza and watching everyone else become a mother.

Over the last four weeks I’ve used every ounce of brain space that I once reserved for progesterone dosages and ultrasound appointments to retrain myself to eat. Knowing myself well enough to know follow-through isn’t my strongest quality when it comes to a new routine, I joined one of the medically-supervised weight loss clinics that seem to be popping up on every corner. The staff has been supportive and has helped me address the areas of emotional eating that are the biggest triggers and challenges for me. I feel better, and I’m doing really well on their program. I’ve said goodbye to sugar (again), and have actually started to like the taste of Greek yogurt. I belong in a Dannon commercial.

I’m going to tick that 20 pounds off and keep going until we’ve pulled together the financials for another stim round. I can’t be the thing standing in my way of being a mom, so I’m not going to be.

Second opinions

The rollercoaster of emotion hasn’t stopped since my chemical pregnancy. Although I’d said before going into this IVF cycle that it would be our last one, I’m reevaluating the options. I feel pulled to continue IVF because I’m emotionally very connected to a successful pregnancy when I’ve only experienced unsuccessful ones for no obvious reason.

Last week I met with my doctor as a post-mortem this third IVF cycle. He’s a lovely, obviously caring man who has more than 30 years of experience with infertility. He’s the Peyton Manning of reproductive endocrinologists. He’s got that time and many wins under his belt; he’s consistent. Then he has a patient like me. During our appointment he referred to me, albeit very kindly, as an anomaly and his personal project. He’s determined to make me a mother in the same way that Peyton was determined to come back after neck surgery and win another Superbowl. No, this metaphor isn’t over-the-top at all, I don’t know what you’re talking about.

manning

As I anticipated, there’s not yet a good explanation for why five perfectly normal-looking embryos haven’t resulted in a sustainable pregnancy. He showed me the math of it and it was incredibly depressing.

So how does he recommend we move forward? The simplest possible response is another biopsy to check for my old nemesis chronic endometritis, and while we’re painfully removing my uterine tissue, reserve a sample for the ERA test, too. My lining is, perhaps, optimal for embryo transfer too early or too late for the standard progesterone window. The ERA test has been growing in popularity in the infertility community (I’d actually asked about it prior to my chronic endometritis diagnosis), but my clinic has only performed the test three times to date as they tend to be pretty conservative on new tech and labs.

Given that we have one remaining embryo, Kristoff, he also suggested that I consider another stim cycle to create more embryos and PGS test the whole lot of them to weed out the shoddy ones. We considered PGS in our first go ’round, but the added cost prevented us from moving forward.

Again, none of these recommendations came as a surprise.

What’s next? We’ve decided to get a second opinion. I really like my clinic, my doctor, and of course the greatest nurse on the planet, but my husband and I both feel like we’d be remiss if we didn’t at least talk to another doctor before making a decision. So I’ll be meeting with another doc, who has successfully helped two friends get pregnant via IVF, in a few weeks. His clinic also has a great reputation, and I’ve heard their treatment protocols are a bit less conservative, too.

 

#TheStruggleIsReal

One week down. 

As someone who struggles with depression, I often have to focus on how far removed I am from my trigger incident to move forward. It’s a coping mechanism I’ve had in place since I was a teenager to remind me that I can move forward.

I work for a large company where we have our own campus. During the workday I spent 99 percent of my time in one building. In the last week I’ve encountered seven new pregnant women. This is in addition to the handful I’d already seen in the cafe or milling about in the hallways. I can’t escape them as I’m slowing expelling my hopes and dreams onto a maxi pad. I’ve heard all of the “it’s in the water” jokes. Trust me, it’s not.

Sorry if that maxi pad bit was too morbid. I’m feeling a touch filter-less.

Emotionally I’m all over the place. My mood turns on a dime. I remind myself that it’s okay to be upset; not only am I grieving another loss, but I’m also facing an enormous decision about what comes next. I spend a lot of time feeling lost. A lot of time feeling jealous of every mom or dad who posted a first day of school photo on Facebook or Instagram. For as much as I want to believe I’ll make that same post someday, the reality is that I may not. And someday isn’t now. Or tomorrow. Or even next year.

I’ve had so much support in the last week that I should be bursting with gratitude. And I am. I am incredibly grateful for the well wishes and the amen, sistas. You all completely understand these feelings. This insane emotional rollercoaster that you both desperately want to get off and are too afraid to leave behind.

whatsucks

Four-day pregnancy

Last Wednesday night I had a dream that my beta test was negative.

On Thursday morning I woke up, still recalling the dream, and wishing it not to be true. I found a leftover home pregnancy test and went to town. It was positive.

I snapped a photo and immediately texted it to my husband, who is working out of town for the next several weeks. He replied with appropriate emojis.

The next two days were spent secretly happy, but cautious. Sore boobs. Intermittent nausea. Fatigue. I decided not to move up my beta, which was scheduled for Saturday. That morning I woke up, went to have my blood drawn, and then waited.

Since it was Labor Day weekend, I heard back a few hours later from the doctor on duty. My beta was, indeed, positive, but my hCG was a little on the low side at 31.5. Commence Googling. I knew enough to know that at four weeks pregnant “normal” hCG levels can vary wildly. As long as the number doubled in 48 hours, things could still be perfectly fine.

I tried to spend the rest of Saturday and Sunday off of Google, and allowed myself to be a little bit excited. I had noticeable symptoms. Before I went to sleep each night I talked to Olaf and Anakin in my head. I told them to stick around, please. I was ready for this. I promised my endometritis-free uterus could take good care of them if they just stuck around.

Monday morning I went in for my second hCG check. I felt like things were on track.

It’s all too easy for me to ask myself why I even bother being happy or excited about anything when it will just be taken from me. That was my first thought when the doctor called on Monday. My levels has dropped by half. She said she was sorry. I could stop the PIO and estrogen. I should expect a slightly heavier period soon. Did I have any questions?

My husband was sitting on the arm chair to my left and I just shook my head as I finished the call. He buried his head in his hands.

This was the briefest of all of my pregnancies. Because I was only four weeks and two days, it’s classified as an “early loss.” A chemical pregnancy. It was barely real. It felt barely real, too, I guess.

We’d said this was going to be our last try. A large part of me still feels that is the right call. The emotions are raw, though. I ask myself, as if on a loop, if I’m okay with never experiencing a baby kick me from inside my body. I don’t know. Why do other women get to experience this, and I don’t? I don’t know. I never seem to get closer to the answers.

These questions and many of these feelings are wrapped up in the idea that my body continues to fail me. I’ve talked in therapy about this at length. I want to forgive my body and make peace with her. I hope that I can.

Of all of the outcomes going into this last FET, pregnant for four days wasn’t one I’d considered.

Learning not to live in fear

If there’s one key thing that I’ve learned from spending time around other women who struggle with infertility, it’s that nearly every one of us lives in fear. When we see two pink lines or hear that we got a positive beta, we can allow ourselves to be happy for a second, but that happiness can quickly turn into fear. Grave thoughts of miscarriages past don’t leave us with passing weeks. The mindset can easily become why be happy when it’s just been taken away from us before?

I’m a few days away from my beta following my FET, and am feeling the sore boobs, fatigue and twinges of nausea. But I know well that those symptoms could just be the meds. I have a positive gut feeling, though. And that makes me anxious. I feel a bit like a tennis ball mid-match. Back and forth.

I was describing to my therapist that while I have this positive gut feeling, the idea of being pregnant again is shrouded in this fear of loss.  Will we tell people — our families and close friends that know about the IVF — this time? Is it worth it?

But on the flip side, if I am pregnant and, heaven willing, am able to carry successfully, will I look back in a few years and know that I didn’t allow myself to fully enjoy the experience? (Because, for real, at this rate I’m not sure I’m going to do it again.)

And then my therapist said something brilliant: If I feel happy because I am pregnant, then give myself permission to be happy. If I’m trying to protect myself by not allowing myself to enjoy it, it won’t work. Protecting myself in this way will not make it any easier should I miscarry again. It will be awful no matter if I was or wasn’t happy or excited.

tumblr_m3rtyerfHZ1qir45xo1_500

I’d never thought of it that way before, but YES! If I should miscarry again, that would be awful. But trying to pretend that I am less invested in the pregnancy won’t make it any easier for me.

As should come as no surprise to anyone reading this, I’m not really a “the world is rainbows and sunshine” kind of person. I’m just not. The “choose happy” mantra isn’t really my jam usually.

So if I am pregnant — if Olaf or Anakin or (gulps) both of them hang in there — then I’ll take the happy moments as they come. Of course I’ll be anxious sometimes, too. Because that’s completely normal. But I’ll work on living outside of the fear. It may be challenging, but this whole damn ordeal has been so I’m familiar.